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Penetrating injury to the left ventricle caused by attempted suicide-a case report
Mara Parentic1, Eva Podolski1, Marin Korda1
1University of Zagreb, School of Medicine, Zagreb 10000, Croatia.
Insights
Penetrating cardiac injuries are rare but life-threatening emergencies. A unique case details a patient surviving a stab wound to the left ventricle, highlighting rare instances of recovery from severe heart trauma.
Area of Science:
- Emergency Medicine
- Cardiovascular Surgery
- Trauma Surgery
Background:
- Penetrating cardiac injuries are uncommon but critical emergencies with high mortality rates, often exceeding 90% including pre-hospital deaths.
- The right ventricle is the most frequently injured chamber due to its anterior thoracic location, while left ventricular injuries portend worse prognoses.
- Prompt medical intervention is crucial for survival in cases of cardiac trauma.
Observation:
- A unique case involved a patient who survived a self-inflicted stab wound directly to the left ventricle.
- The patient sustained a transection of the second diagonal branch of the left anterior descending coronary artery.
- The individual survived the incident after the knife was removed from the chest.
Findings:
- Despite the rarity and severity of left ventricular penetration and associated coronary artery injury, survival is possible.
- This case challenges the typical high mortality associated with left ventricular penetrating trauma.
- Successful management underscores the importance of rapid response in cardiac emergencies.
Implications:
- This case highlights the potential for unexpected survival in severe penetrating cardiac injuries.
- It emphasizes the need for advanced trauma care protocols for cardiac emergencies.
- Further research into factors influencing survival from left ventricular trauma is warranted.
Abstract:
Penetrating cardiac injuries are rare but are one of the most urgent emergencies because they require early intervention in order to prevent death. The mortality rate of such injuries, including pre-hospitalization deaths, goes up to 90%. The most commonly injured heart chamber is the right ventricle since it takes over half of the anterior thoracic wall. The left ventricle is injured less often, but these patients usually have worse prognoses and higher mortality rates because such injuries lead to hemodynamic instability faster. We present a unique case of a suicide attempt in which the patient stabbed himself with a knife, penetrated the left ventricle, and survived even though he transected the second diagonal branch of the left anterior descending coronary artery and pulled the knife out of his chest.
